HEPA Filtration on Reducing Cardiometabolic Risk During Wildfires

摘要 在这项补充研究中，我们建议调查气候变化对健康的影响， 关于荒地火灾加剧的空气污染对人类健康的影响。补充研究将建立在 正在进行的SAPIA研究，“通过室内空气过滤减缓动脉粥样硬化血栓形成的进展，”旨在 评估高效空气过滤器在减少室内PM2.5暴露方面的有效性，以及对 改善动脉粥样硬化血栓形成的结果。SAPIA研究将招募并随访52名年龄在65-84岁之间的参与者 2023-2024年居住在洛杉矶地区，有缺血性心脏病病史，年龄30岁。的目的 这项补充性研究将扩展SAPIA最初的目标，重点研究野火的不利影响 评估住宅HEPA过滤在1）减少室内PM2.5暴露方面的有效性 在野火事件期间和2）减轻野火引起的对急性心血管结果的不良影响 （血压、心率变异性和生物标志物）。我们将利用现有的国家和地区野火和空气 污染监测网络，以监测野火季节（5月至9月）期间的野火事件。我们将 在参与者的住宅地址安装低成本的空气质量传感器，监测室内和室外的PM2.5 程度.通过使用时间序列和扩散模型，我们将验证野火的室内和室外水平- 在HEPA和非HEPA设置中导出PM2.5。这种方法将使我们能够评估 HEPA过滤降低室内PM2.5浓度。一旦确定野火事件，参与者将 被告知填写调查问卷，并使用预分配和自我采集的方式采集尿液和血液样本 检测试剂盒。每日血压（BP）和心率变异性将使用Withings BP监测仪远程采集 和可佩戴的Oura®戒指本研究的优点包括使用了两组随机试验， 在正在进行的SAPIA交叉试验中，可穿戴数字设备用于实时健康监测， 收集血液和尿液样本，从而能够评估野火对健康的急性影响。 这项研究的结果将有助于评估高效空气过滤器作为一种预防工具， 野火引起的空气污染暴露对健康的影响。总之，这项补充研究将有助于 这对了解气候变化加剧的野火对人类健康的影响以及潜在的 HEPA过滤通过减少暴露于野火引起的PM2.5而对健康有益。通过结合国家的- art暴露评估方法，实时健康结果监测和生物样本的自我收集， 这项研究将为野火引起的空气污染与 心血管健康，为该领域未来更大规模的研究铺平了道路。

ABSTRACT In this supplemental study, we propose to investigate the climate change effects on health, focusing specifically on the impact of wildland fire-enhanced air pollution on human health. The supplemental study will be built upon the ongoing SAPIA study, "Slowing Atherothrombosis Progression through Indoor Air Filtration," aiming to assess the effectiveness of HEPA filtration in reducing indoor PM2.5 exposure and the subsequent effects on improving atherothrombosis outcomes. The SAPIA study will enroll and follow up 52 participants aged 65-84 years old with ischemic heart disease history and living in the Los Angeles area in year 2023-2024. The aims of this supplemental study will extend the original SAPIA aims to focus on investigating adverse effects of wildfire exposures and assess the effectiveness of residential HEPA filtration in 1) reducing indoor exposure to PM2.5 during wildfire events and 2) alleviating the wildfire-induced adverse effects on acute cardiovascular outcomes (blood pressure, heart rate variability and biomarkers). We will use existing national and regional wildfire and air pollution monitoring networks to monitor wildfire events during the wildfire season (May-September). We will employ low-cost air quality sensors at participants' residential addresses to monitor indoor and outdoor PM2.5 levels. By using both time-series and dispersion models, we will validate the indoor and outdoor levels of wildfire- derived PM2.5 in both HEPA and non-HEPA settings. This approach will enable us to assess the effectiveness of HEPA filtration in reducing indoor PM2.5 concentrations. Once a wildfire event is identified, participants will be informed to complete questionnaires and collect urine and blood samples using pre-distributed and self-collection test kits. Daily blood pressure (BP) and heart rate variability will be remotely collected using Withings BP monitors and wearable Oura® rings. The advantages of this study include the use of a two-arm randomized trial nested within the ongoing SAPIA cross-over trial, wearable digital devices for real-time health monitoring, and self- collection of blood and urine samples, which enable the assessment of the acute health effects of wildfires. Findings of this study will help to assess the effectiveness of HEPA filtration as a preventive tool for the adverse health effects of wildfire-originated air pollution exposure. In conclusion, this supplemental study will contribute significantly to understanding the impact of climate change-enhanced wildfires on human health and the potential health benefits of HEPA filtration by reducing exposure to wildfire-originated PM2.5. By combining state-of-the- art exposure assessment methods, real-time health outcome monitoring and self-collection of biosamples, this study will provide valuable insights into the relationship between wildfire-originated air pollution and cardiovascular health, paving the way for future larger-scale studies in this field.